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Evaluating the Ability of the New Subclassification to Prognosticate Outcomes Following Hepatectomy for Patients with HBV-Related HCC

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Abstract

Background

Recently, experts proposed subclassification for BCLC B patients. In this study, we aimed to evaluate the efficient of subclassification of patients with hepatitis B virus-related hepatocellular carcinoma (HCC) in Barcelona Clinic Liver Cancer (BCLC) staging system.

Methods

Seven hundred twenty-nine consecutive hepatitis B virus-related HCC patients with BCLC stage B classification who underwent hepatectomy in the period 2006–2012 were retrospectively analyzed. Patients were reclassified based on the new proposed subclassification of the BCLC B stage from B1 to B4. The prognosis of subclassification was tested using Kaplan-Meier statistics analysis.

Results

There were 145 (19.9%), 480 (65.8%), 62 (8.5%), and 42 (5.8%) patients in B1, B2, B3, and B4, respectively. The result suggested that overall and tumor-free survival rates among the B1, B2, and B3 subclassification in the Bolondi system had significant difference (P < 0.05). However, no significant difference was found between B3 and B4 subclassifications. Cox regression showed that BCLC B subclassification, largest/smallest diameter, and anatomic liver resection were independent predictors of tumor-free survival. BCLC B subclassification and anatomic liver resection were independent predictors of overall survival.

Conclusions

The subclassification of BCLC stage B can be used in patients with HBV-related HCC who underwent curative intent hepatectomy. Patients in BCLC B1 and B2 subgroups should be treated more aggressively than patients in B3 and B4 subgroups. B3 and B4 groups should be merged for patients with HBV-related HCC who underwent curative intent hepatectomy.

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Funding

This study was funded by the foundation of innovation seeding project of Science & Technology Department of Sichuan Province [2017-64] and the cooperative project of Nanchong City with North Sichuan Medical College [NSMC20170461].

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Authors and Affiliations

  1. The Third Affiliated Hospital of Soochow University, Soochow University, Suzhou, Jiangsu, China

    Yunhong Tian

  2. Department of General Surgery, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College, Nanchong, Sichuan, 215006, China

    Yunhong Tian, Huan Lyu & Yunhong He

  3. Graduate school of Xinjiang Medical University, Xinjiang, China

    Hari Krishna Kanduri

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  1. Yunhong Tian
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  2. Huan Lyu
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Corresponding author

Correspondence to Yunhong Tian.

Ethics declarations

This study was approved by the Ethics Committee of Nanchong Central Hospital

Conflict of Interest

The authors declare that they have no conflicts of interest.

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Tian, Y., Lyu, H., He, Y. et al. Evaluating the Ability of the New Subclassification to Prognosticate Outcomes Following Hepatectomy for Patients with HBV-Related HCC. J Gastrointest Canc 50, 400–407 (2019). https://doi.org/10.1007/s12029-018-0085-4

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  • DOI: https://doi.org/10.1007/s12029-018-0085-4

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